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Navigating U.S. Health Insurance as an E2 Visa Holder

Navigating U.S. Health Insurance as an E2 Visa Holder

Getting through the E2 visa process is only the first step in your journey to living and working in the U.S.  Once you are approved for your E2 visa, there are many things to do in order to adjust to life in the States.

As you may have heard, the U.S. health insurance industry is large and can be somewhat confusing.  It’s important to note that all E2 visa holders should have health insurance.  To not have health insurance can be incredibly costly.  Hospital bills, even for only one or two days in the hospital, can run more than $100,000.  In addition, no E2 visa holder should apply for Medi-Cal or any other federal or state-assisted medical coverage.  This is crucial, since getting this type of health insurance may be considered government benefits; and receiving these benefits could put your status in jeopardy or ruin your opportunity to renew the E2 visa.

Karim Hemani, a certified Health Insurance Agent with Covered California, gives us some other important things to consider when moving to the U.S.

“First of all, the timing of your health insurance application is crucial,” Hemani said.  “An application for coverage must be submitted within 60 days of the date the person enters the United States as an E2 visa holder or E2 visa derivative. If you miss this 60-day window, the visa holder must wait until the Open Enrollment period to apply for coverage that would start the 1st day of the following year.”

Other important things to consider are the types of insurance you want to get and the amount of coverage you want to get.

Types of Insurance

There are three types of insurance: PPO, HMO, and EPO.  With a PPO, it will be more expensive monthly premium, but you will be able to choose the doctors you visit within the PPO network of doctors.  With an HMO, the premiums are less expensive, but you will only be able to see medical specialists after receiving a referral from your Primary Care Physician. In addition, fewer doctors work with HMO plans, so you will have fewer options when it comes to which doctors you see. With an EPO plan, the premiums are priced in the middle of an HMO & PPO, but you will be restricted to only receiving care in the county in which you reside.

Please note – before you visit your doctor, you should call the office to confirm that they are contracted (aka IN-Network) with your type of insurance.  You should also call the insurance company to ensure that the doctor is IN-Network with the insurance (sometimes there is misinformation on the website).

Coverage Options

Health insurance coverage varies widely from comprehensive to catastrophic.  Generally speaking, the better coverage you get, the more expensive the premiums will be.

  • If you have comprehensive coverage, you will have low deductibles (the amount you must pay in a year before insurance pays all charges) and low co-pays (the flat fee you will pay for all medical services).
  • If you have catastrophic insurance, this will basically cover anything that is very expensive. For a typical catastrophic insurance coverage, the deductible will be $6,000 or so.  This means that your insurance won’t cover medical expenses incurred under $6,000 in one year.  This type of insurance is best if you don’t visit the doctor often, and you want to avoid a $100,000 medical bill.  If you have an extensive stay in the hospital for a catastrophic injury or illness, you will pay $6,000. From there, the insurance company should cover the rest.

How to Use Insurance

As mentioned above, before you make an appointment with a doctor, you should call that office and your insurance company to ensure that the doctor is In-Network with your insurance.  If you visit a doctor that is not IN-Network with your insurance, you will pay for the entire bill and insurance will pay nothing unless it is an emergency situation.

When you get the doctor’s office, you will present your insurance card.  You may have a co-pay, which will be a flat fee.  Usually, co-pays are somewhere between $10-$100.  In addition, you should know that you may get another bill from the doctor’s office for charges incurred that were not covered by insurance.  However, that bill will come later in the mail. The bill will have the prices for the services and the amount that insurance covered.

California Residents

For those residents of California, you will have two different options:

  • Going through the insurance companies directly OR
  • Signing up for Covered California

Covered California is a program that allows for tax credits based on your Modified Adjusted Gross Income, which is the net income from your business after all allowable business deductions plus any W2 income, foreign-earned Income, non-taxable Social Security benefits and interest.

“Actually, most people who stay on Covered California for the long haul and benefit from these tax credits are self-employed individuals because their gross income can be $200 – $300k, but after they deduct all their allowable business expenses their MAGI is often much less,” Hemani said.  “So depending on the MAGI, the insured could possibly receive tax credits to help reduce the monthly premium.”

In other words, the health insurance industry in the U.S. can be confusing and overwhelming – even for people who have lived in the United States their entire lives.  Don’t handle health insurance on your own.  Speak to a professional.  For more information on health insurance, particularly in the state of California, please contact Karim Hemani at